How Couples Therapy Works, According to Couples Therapists

Knowing what makes couples therapy effective could increase the chances of it working for you.

Couples therapy can help individuals cope with anything from infidelity to sexual dissatisfaction, but understanding how it works increases the likelihood of it being effective. Which is a shame, because couples therapy is a tricky concept to grasp. It’s not quite the same as individual therapy, it requires a willing partner, and it combines several clinical approaches that vary by therapist.

“I use a hybrid of styles, as each couple is different,” Jenn Kennedy, a marriage and family therapist, told Fatherly. “Some need help with sex, while others need assistance communicating, deescalating, or grieving. I also use a heavy dose of humor to lighten things up and help build trust and perspective.”

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Emotionally-Focused Therapy, developed by psychologist Sue Johnson, is one of the most popular strategies among couples therapists. This approach involves helping both parties understand their attachment styles, along with a healthy dose of old-fashioned meditation. Studies suggest it’s about 75 percent effective. Another approach is the Gottman Method, developed by husband and wife psychologists John and Julie Gottman. This model consists of nine separate components to rebuilding a healthy relationship — including making “love maps” and exploring attachment theory. And then there are the less trafficked Imago Relationship Therapy, narrative therapy, attachment therapy styles.

Like most therapists, Kennedy prefers a multidimensional approach that incorporates each of these models. By tracking how both parties feel and remaining being impartial, Kennedy provides “a container so when they have conflict, it doesn’t feel overwhelming — like at home.” Couples sessions tend to be lengthier than individual ones, Kennedy adds, which makes sense since two individuals are contributing. “They tend to come in wanting a specific thing to improve, such as sex, communication, or infidelity,” she says. “Once we address that item, they taper down and may only come for maintenance.”

Of course, couples therapy doesn’t always work. One issue is when the couple does not agree with or understand their therapist’s approach. That’s why it’s important for couples to talk to potential therapists about their specific issues and the clinician’s areas of expertise. Couples therapy might also fail if one person does not want to change or buy into the process. In such cases, therapist Louise Head recommends discernment counseling, which can help couples decide whether they want to invest in couples therapy before they’re locked into sessions doomed to fail. “Couples counseling can begin after discernment counseling if both partners choose to recommit to the relationship,” Head told Fatherly.

Kennedy agrees that the hardest part of couples therapy is that one party usually is dragging the other in. “Therapy is about change — often of perspective, but also of behavior. If one person changes and the other doesn’t, the system can’t shift,” Kennedy says. “If both partners aren’t committed to the work and in agreement about the goals, it likely won’t go anywhere.”

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